Association of atopic dermatitis with smoking: A systematic review and meta-analysis

Research output: Contribution to journalReviewResearchpeer-review

  • Robert Kantor
  • Ashley Kim
  • Jacob P Thyssen
  • Jonathan I Silverberg

BACKGROUND: Tobacco exposure might be a modifiable risk factor for atopic dermatitis (AD).

OBJECTIVE: We examine the association between AD and exposure to tobacco smoke.

METHODS: We performed a systematic review and meta-analysis of observational studies (n = 86) in MEDLINE, EMBASE, Scopus, and Cochrane Library (1823-2015). Quality of evidence was assessed using the Newcastle-Ottawa Scale (NOS). A meta-analysis was performed using random-effects models to estimate pooled odds ratios (OR). Subset analyses were performed for different ages (children, adult), regions, study designs (cross-sectional, longitudinal), study sizes (<5000, ≥5000), study quality (NOS score <6, ≥6), and amount of smoking (mild, extensive).

RESULTS: A diagnosis of AD was associated with higher odds of active smoking (OR 1.87, 95% confidence interval 1.32-2.63) and exposure to passive smoke (OR 1.18, 95% confidence interval 1.01-1.38), but not maternal smoking during pregnancy (OR 1.06, 95% confidence interval 0.80-1.40). The association between active smoking and AD remained significant in children and adults, all continents studied, and study sizes, but all were cross-sectional designs and had NOS score 6 or greater. Passive smoke was associated with AD in children and adults, cross-sectional studies, South/Central American and African studies, study size less than 5000, and NOS score less than 6.

LIMITATIONS: AD severity and distribution were not assessed.

CONCLUSIONS: Active and passive exposure to smoke are associated with increased AD prevalence.

Original languageEnglish
JournalJournal of the American Academy of Dermatology
Issue number6
Pages (from-to)1119-1125.e1
Number of pages8
Publication statusPublished - Dec 2016

    Research areas

  • Africa, Age Factors, Asia, Central America, Cross-Sectional Studies, Dermatitis, Atopic, Europe, Female, Humans, North America, Pregnancy, Risk Factors, Smoking, South America, Tobacco Smoke Pollution, Journal Article, Meta-Analysis, Review

ID: 177054369